Eating Disorders
Dr. Ahmed Elabwabi Abdelwahab
MD. Psychiatry
Assisstant professor
Albaha university
www.psychlotron.org.uk
Eating Disorders
Some statistics
• Eating disorders have increased threefold in the last
50 years
• 10% of the population is afflicted with an eating
disorder
• 90% of the cases are young women and adolescent girls
• Up to 21% of college women show sub-threshold
symptoms
• 61% of college women show some sort of eating
pathology
Three Types of Eating Disorders
• Anorexia nervosa- characterized by a pursuit
of thinness that leads to self-starvation
• Bulimia nervosa- characterized by a cycle of
bingeing followed by extreme behaviors to
prevent weight gain, such as purging.
• Binge-eating disorder- characterized by
regular bingeing, but do not engage in
purging behaviors.
• Anorexia is a misnomerappetite is normal Distorted
body image.
• Excess fear of fatness And
excess emphasis on
thinness.
Anorexia Nervosa
• Restriction of energy intake
resulying in significant weight
loss.
• Poor sexual development in
adolescents
• Low sexual interest in adults
Anorexia nervosa
• May exhibit unusual behaviors with
regards to food.
– preoccupied with thoughts of food, and may
show obsessive-compulsive tendencies
related to food
• may collect recipes or prepare elaborate meals
for others.
• Cutting foot into very small pieces.
• Restrictive type: high restriction of
food
• Binge eating/purging type:
–Regorous dieting with intermittent
binging ( large amount of food in
short period)
–Uses: vomiting (or emetics use),
laxatives, duiretics.
Complications of
anorexia nervosa
Anorexia
Risk of Death:
The Deadliest of all
Psychological Disorders
Management
• Admission and:
– Restoring nutritional status
– Manage complications such as
dehydration and electrolyte imbalance.
• Combination of behavioral ways and
individual psychotherapy and family
education.
• SSRIs and TCAs may be tried.
Bulimia Nervosa
• Qualitatively distinct from anorexia
• More common than anorexia nervosa.
• characterized by:
– binge eating
– Inappropriate ways of avoiding weight gain.
• A binge may or may not be planned
– marked by a feeling of being out of control
• The binge generally lasts until the
individual is uncomfortably or painfully
full
Bulimia Nervosa
• Usually in females.
• Common triggers for a binge
–dysphoric mood
–interpersonal stressors
–Intense hunger after a period of intense
dieting or fasting
–feelings related to weight, body shape,
and food are common triggers to binge
eating
Bulimia Nervosa
• Feelings of being ashamed after a binge
are common
– behavior is kept a secret
• Tend to adhere to a pattern of restricted
caloric intake
– usually prefer low-calorie foods during times
between binges
More on bulimia nervosa
• Later age at the onset of the disorder
• Are able to maintain a normal weight
• Will not seek treatment until they are
ready
• Most deal with the burden of hiding their
problem for many years, sometimes well
into their 30’s
Two subtypes
• purging type
– self-induced vomiting and laxatives as a
way to get rid of the extra calories they
have taken in
• non-purging type
– use a period of fasting and excessive
exercise to make up for the binge
Complications
of bulimia
nervosa
Management
•CBT
•SSRIs
Risk Factors for developing
an eating disorder
–Personality/psychological
factors
–Family influence
–Media
–Subcultures existing within
our society
Personality/Psychological Factors
•
•
•
•
•
•
Sense of self worth based on weight
Use food as a means to feel in control
Dichotomous & rigid thinking
Perfectionism
Poor impulse control
Inadequate coping skills
Media and Cultural Factors
• Culture bound syndrome
• Belief that being thin is the answer to
all problems is prevalent in western
culture
• Bulimia can be influenced by social
norms
–It can be seen as a behavior, which is
learned through modeling
The Celebrity Thin Ideal
Challenges to treatment
• Lack of motivation to change
– intrinsically reinforced by the weight loss,
because it feels good to them
– may deny the existence of the problem, or the
severity of it
Lack of insight
– Not really about food.